INSTRUMENT DECONTAMINATION


Wayne Spencer responded that there is a question over how independent some of the AE(D)s are in the devolved administrations from the NHS. Some may argue there is a conflict of interest, as they are working for the same health body, with the same financial ‘pot’. Another delegate pointed out that AE(D)s can bring learning from other hospitals, which is extremely valuable.


She added that actions that have


already been recommended by the Infection Prevention team are often subsequently reiterated by the AE(D) – but only then are they taken seriously; suddenly, it becomes “really important to implement them”. Other views put forward by the audience included the fact that AE(D)s can help with culture change – it is easier to hear you are doing something wrong from an outside party.


References 1 Nuffield Trust, The planning and organisation of central syringe services, 1957. Accessed at: https://www. nuffieldtrust.org.uk/research/the- planning-and-organisation-of-central- syringe-services


2 Nuffield Trust, Studies of sterile supply arrangements for hospitals: Present sterilizing practice in six hospitals, 1958. Accessed at: https://www.nuffieldtrust.


The CSC


The CSC was formed in 1960 as a result of the enthusiasm of a small group interested in sterilisation processes and the provision of sterile supplies in hospitals, brought together by Professor Michael Damady. As topics discussed at meetings, and indeed the character of the meetings themselves, have changed over the years, the central themes have been maintained: applied and basic research topics; the general interchange of information, and the generation of CSC guidance documents, using multi-disciplinary members. Several successful national groups have emerged from the Club’s


org.uk/research/studies-of-sterile-supply- arrangements-for-hospitals-present- sterilizing-practice-in-six-hospitals


3 https://blog.sciencemuseum.org.uk/ remembering-the-devonport-incident-50- years-on/


4 The Clothier Report, July 1972. Accessed at: https://api.parliament.uk/historic- hansard/commons/1972/jul/12/dextrose- solution


5 Butin, M., Dumont, Y., Monteix, A. et al. Sources and reservoirs


membership, including the Institute for Decontamination Sciences (IDSc and formally the ISSM), the Infection Prevention Society (IPS, formally ICNA), and the Healthcare Infection Society (formally Hospital Infection Society). The 60th Anniversary Annual Scientific Meeting took place on 4-5 April 2022, at the Crowne Plaza Hotel, Stratford Upon Avon. The next Annual Scientific Meeting will take place on 3-4 April 2023 in Newcastle Upon Tyne. For further details, visit: https://centralsterilisingclub.org/ For membership please contact: membership@centralsterilisingclub.org


of Staphylococcus capitis NRCS-A inside a NICU. Antimicrob Resist Infect Control 8, 157 (2019). https://doi. org/10.1186/s13756-019-0616-1


This article, titled ‘Decontamination: past, present and future’, first appeared in the June 2022 issue of HEJ’s sister publication, The Clinical Services Journal. HEJ thanks the Editor of ‘CSJ’, Louise Frampton, who authored the piece, for allowing its reproduction here in slightly edited form.


are organisationally independent of the production teams, so that if there is a question mark about the suitability of a batch of product, the quality teams can reject such a batch independently of the influence of a Production Manager. The latter has schedules to meet, and therefore a vested interest in getting production batches released for use. However, ultimately all teams report to a corporate CEO, who would need to resolve any disputes. In a government-run healthcare


system, one possible structure is that there are engineering functions providing expert advice, but which operate independently of the sterile service production departments within the system’s hospitals. Clearly such engineering functions are independent of production, and can provide expert advice, however inconvenient such advice may be (for example that the hospital needs to spend significant funds to upgrade a facility). A good example of such a structure is that which operates within Wales, where the AE(D) role is operated from a Shared Services Department, which is totally independent of all the healthcare units in Wales, which are totally separate, and manage themselves autonomously.


However, in any government-run healthcare setting, all organisational structures will ultimately report to a government departmental Minister, politically responsible for healthcare provision.


In a quasi-independent healthcare


system, such as is found in England, NHS autonomous Trusts will seek expert advice from independent contractors (such as AE(D)s), who will provide services to such Trusts against a supplier contract of engagement. Such AE(D)s are completely independent of the Trust, but the continuation of the contract could be influenced by the nature of the advice given. The phrase, ‘he who pays the piper calls the tune’ could be an influencing factor in decision-making processes.


Conclusions The conclusion which must be drawn from the arguments we have presented is that hospitals do indeed need independent expert practitioners, such as AE(D)s, who will operate professionally, and with a high level of integrity in providing independent, impartial advice. However, it is not unreasonable to suppose that such practitioners can either be employed by the hospital, but work within a separate department, or operate as an independent


contractor. The key is whether the organisational structure ensures the independence of the role.


Dr Brian Kirk, Chair of the IHEEM


Decontamination Technical Platform and AE(D) Group.


Graham Stanton,


Chair of the IHEEM AE(D) registration panel.


References 1 Frampton L. Decontamination: past, present and future. The Clinical Services Journal 2022: 21(6): 19-24.


2 EN ISO/IEC 17020:2012, Conformity assessment - Requirements for the operation of various types of bodies performing inspection. International Organization for Standardization, Geneva. 2012.


Further reading n Stanton G. A focus on the role and responsibilities of the AE(D). Health Estate Journal 2017; 71(1): 30-33.


n Health Technical Memorandum 00. Policies and Principles of Healthcare Engineering, Department of Health (England), 2014.


September 2022 Health Estate Journal 31


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